A young patient with atypical type-B Wolff–Parkinson–White syndrome accompanied by left ventricular dysfunction

Publication date: February 2015 Source:Journal of Arrhythmia, Volume 31, Issue 1 Author(s): Takahiro Takeuchi , Takeshi Tomita , Hiroki Kasai , Daisuke Kashiwagi , Koji Yoshie , Tomonori Yaguchi , Yasutaka Oguchi , Ayako Kozuka , Milan Gautam , Hirohiko Motoki , Ayako Okada , Yuji Shiba , Kazunori Aizawa , Atsushi Izawa , Yusuke Miyashita , Jun Koyama , Minoru Hongo , Uichi Ikeda A 15-year-old asymptomatic male patient presented with an electrocardiographic abnormality and left ventricular (LV) dysfunction (left ventricle ejection fraction of 40%) in a physical examination performed 2 years previously. LV dysfunction did not improve despite optimal medical therapy for dilated cardiomyopathy. Twelve-lead electrocardiography revealed a normal PR interval (138ms) with a small delta-like wave in V2, but not a typical diagnostic wave that could be diagnosed as Wolff–Parkinson–White (WPW) syndrome by an electrocardiogram auto-analysis. Transthoracic echocardiography showed a remarkable asynchronous septal motion. An electrophysiological study was performed to exclude WPW syndrome. An accessory pathway (AP) was revealed on the lateral wall of the right ventricle, and radiofrequency catheter ablation was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and LV function improved. The intrinsic atrioventricular nodal conduction was very slow (A-H, 237ms). The results of electrocardiogram auto-analysis could not be used to c...
Source: Journal of Arrhythmia - Category: Cardiology Source Type: research